阿司匹林和华法令在预防复发性缺血性卒中方面作用相等
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WESTPORT, CT (Reuters Health) - Aspirin and warfarin are equally safe and effective in the prevention of recurrent ischemic stroke, according to results from a 48-center trial reported in the November 15th issue of The New England Journal of Medicine.
Though previous trials have studied various drugs in the prevention of noncardiogenic, recurrent ischemic stroke, the authors explain, no trial had determined whether anticoagulants were superior to antiplatelet drugs in preventing such strokes.
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Dr. Jay P. Mohr from Columbia Presbyterian Medical Center in New York and colleagues in the Warfarin-Aspirin Recurrent Stroke Study Group compared the outcomes of 2206 patients who received warfarin or aspirin after they experienced a noncardiogenic ischemic stroke. Most patients were followed for 2 years.
Altogether, 70.7% of international normalized ratio values for patients in the warfarin group stayed in the targeted range, the report indicates, with 13.0% exceeding the targeted INR and 16.3% falling below the target.
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The two groups did not differ in the overall rates of death or recurrent ischemic stroke, the authors report. The 2-year probability of an event was 17.8% with warfarin and 16.0% with aspirin (p = 0.25).
Major hemorrhage rates did not differ between the treatments, the results indicate, but patients in the warfarin group experienced more minor hemorrhages than did patients in the aspirin group.
"Warfarin and aspirin are both effective and comparably safe for serious hemorrhage risk," Dr. Mohr told Reuters Health. "Warfarin did not show itself the clearly superior drug as it has for atrial fibrillation, and aspirin did not show itself the clearly safer drug for serious hemorrhagic complications."
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"The prevention of recurrent stroke in patients with noncardioembolic stroke remains a frustrating problem of major importance," Dr. William Powers from Washington University School of Medicine in St. Louis, Missouri writes in a related commentary. "At this time, there is no evidence from clinical trials to support the use of oral anticoagulant therapy."
Dr. Powers adds, "Ongoing trials will determine whether there are associated factors that define subgroups of patients who will benefit from oral anticoagulant therapy."
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Dr. Mohr agreed. "More details are in the offing on treatment and risk effects for clinically defined subtypes of stroke," he said.
In the meantime, the authors conclude in the journal, "Aspirin, either alone or in combination with some other antiplatelet agents, appears to be a well-justified choice for the prevention of recurrent ischemic stroke."
N Engl J Med 2001;345:1444-1451,1493-1495.
-Westport Newsroom 203 319 2700
Exception:java.sql.SQLException: Closed Statement: next, 百拇医药
Though previous trials have studied various drugs in the prevention of noncardiogenic, recurrent ischemic stroke, the authors explain, no trial had determined whether anticoagulants were superior to antiplatelet drugs in preventing such strokes.
, 百拇医药
Dr. Jay P. Mohr from Columbia Presbyterian Medical Center in New York and colleagues in the Warfarin-Aspirin Recurrent Stroke Study Group compared the outcomes of 2206 patients who received warfarin or aspirin after they experienced a noncardiogenic ischemic stroke. Most patients were followed for 2 years.
Altogether, 70.7% of international normalized ratio values for patients in the warfarin group stayed in the targeted range, the report indicates, with 13.0% exceeding the targeted INR and 16.3% falling below the target.
, 百拇医药
The two groups did not differ in the overall rates of death or recurrent ischemic stroke, the authors report. The 2-year probability of an event was 17.8% with warfarin and 16.0% with aspirin (p = 0.25).
Major hemorrhage rates did not differ between the treatments, the results indicate, but patients in the warfarin group experienced more minor hemorrhages than did patients in the aspirin group.
"Warfarin and aspirin are both effective and comparably safe for serious hemorrhage risk," Dr. Mohr told Reuters Health. "Warfarin did not show itself the clearly superior drug as it has for atrial fibrillation, and aspirin did not show itself the clearly safer drug for serious hemorrhagic complications."
, http://www.100md.com
"The prevention of recurrent stroke in patients with noncardioembolic stroke remains a frustrating problem of major importance," Dr. William Powers from Washington University School of Medicine in St. Louis, Missouri writes in a related commentary. "At this time, there is no evidence from clinical trials to support the use of oral anticoagulant therapy."
Dr. Powers adds, "Ongoing trials will determine whether there are associated factors that define subgroups of patients who will benefit from oral anticoagulant therapy."
, 百拇医药
Dr. Mohr agreed. "More details are in the offing on treatment and risk effects for clinically defined subtypes of stroke," he said.
In the meantime, the authors conclude in the journal, "Aspirin, either alone or in combination with some other antiplatelet agents, appears to be a well-justified choice for the prevention of recurrent ischemic stroke."
N Engl J Med 2001;345:1444-1451,1493-1495.
-Westport Newsroom 203 319 2700
Exception:java.sql.SQLException: Closed Statement: next, 百拇医药